GHSV 1

[Dee74]

I am a 60 year old female. I had my first GHSV 1 outbreak 2 months ago. I went to urgent care, had quite a few blisters and sores. The NP said she got a good sample. I was positive for HSV1, negative for HSV2. This outbreak happened about a week after oral sex with a partner I have only been with 2 times before. He has a history of cold sores but hasn’t had an outbreak in 2 years.

I am not looking to blame him. The thing is I have had cold sores myself. At least 20 years ago was the first outbreak. I don’t remember the last time I had a cold sore.

I took Valtrex 1g, 2xday. 10 days. my GHSV1 was healing well. When I ended the course of Valtrex less than a week later I started getting cold sores. I became VERY anxious! Now I am taking 500mg Valtrex daily to suppress.

I don’t know what to do or what to expect. I have has oral HSV1 for a long time, now GHSV 1. I am afraid to go off the Valtrex. My understanding having both is not very common. My understanding is that over time the risk of transmission is low … what does that mean for someone like me?

I live in Portland OR. Is there a local support group? I have been told about “hidden” Facebook groups. I am not comfortable with that.

Thank you for your support!

[Dee74]

I want to clarify my questions.

Given I have OHSV 1 for over 20 years, now GHSV 1 diagnosed Oct 1, 2022. Am I still considered to have the same risk for transmission as a newly diagnosed person? I am trying to make sense out of this JAMA article.

https://jamanetwork.com/journals/jama/fullarticle/2797619

It seems to say that shedding rates are different for newly, primary infections vs secondary/non primary, which I think is me.

Primary shedding rate: 12.1% at 2 months, 7.1 % at a year, 1.3 % at 2 years

This is quite new to me, I am still learning. I believe that the article says non primary shedding has lower rates.

In addition, I have read that suppression therapy cuts the above risk in half.

Lastly, genital to genital transmission is rare. It tends to be transmitted orally. So if I am taking antivirals, genital transmission risk is very low … there is higher risk (even that is very low) of giving my partner OHSV 1 through oral sex. My partner got his first cold sore as a child, which makes genital transmission even less likely.

I am a total nerd, I need to understand risk, it helps me process this emotionally & will help me communicate with future partners.

1. Please correct anything I have stated that is wrong.
2. Is there anything else I can do to determine/reduce my risk for transmission?
(Besides the obvious condoms, etc …)
3. Is there a local support group in Portland Oregon? I read about hidden Facebook groups, that makes me uncomfortable.

Thank you for this forum!

[Terri Warren]

Your situation is unusual but not unheard of, certainly.
Your shedding rate, because you’ve had it orally, should be lower than someone who has never had it before anywhere, though we don’t have research to prove that.
You are not a real risk to your partner that has oral HSV but as you can see it happens but very rarely that you get the virus in a new location. Oral antiviral would like reduce the risk of transmission but we don’t have good data on that.

I used to be the medical advisor for the herpes support group in Portland but I don’t know if it still exists – did you try to Google it?

Sheryl Horwitz, NP is an excellent resource in Portland if you need to see someone with high levels of knowledge about HSV

Terri

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